A patient ten days after induction chemotherapy has temperature 38.6°C, neutrophils 0.1 × 10⁹/L, systolic pressure 82 mmHg and lactate 3.8 mmol/L.

Question

A patient ten days after induction chemotherapy has temperature 38.6°C, neutrophils 0.1 × 10⁹/L, systolic pressure 82 mmHg and lactate 3.8 mmol/L. Blood cultures are difficult to obtain. What is the immediate antimicrobial principle?

Accepted Answer

Give broad intravenous antibiotics within one hour of presentation

Answer

Use oral combination antibiotics because the calculated MASCC score is favourable

Answer

Give empirical vancomycin monotherapy pending blood-culture identification

Answer

Obtain paired cultures and susceptibility data before selecting antimicrobial therapy

Answer

Obtain CT imaging to identify an anatomical focus before selecting antibiotics

Hairy Cell Leukaemia — RACP Adult Medicine MCQ

A patient ten days after induction chemotherapy has temperature 38.6°C, neutrophils 0.1 × 10⁹/L, systolic pressure 82 mmHg and lactate 3.8 mmol/L. Blood cultures are difficult to obtain. What is the immediate antimicrobial principle?